Periodic reports are prepared to brief upper management in the Fire Department and the Medical Director.

Tracking Infectious Disease with Seattle Fire Real-Time System Data - Part I (December 2010).  This is the first part of an overall evaluation of the Seattle Fire Department Infectious Disease Monitoring program.  Included is a survey of prior research on syndromic surveillance, an approach to evaluating the program and detailed description of the data sources and the First Watch© monitoring program.

Tracking Infectious Disease with Seattle Fire Real-Time System Data - Part II (FINAL - October 2012). This is the second part of an overall evaluation of the Seattle Fire Department Infectious Disease Monitoring program and includes the results of the statistical analysis that supports the conclusion that Infectious Disease Monitoring Program is valuable in alerting public health officials and others about an unexpected infectious disease outbreak.  Attachment A and Attachment B contain detailed statistical analysis supporting the findings and conclusions contained in Part II.

December 2009 Report:  The second report documents the close association of symptoms found in the field during the second H1N1 outbreak and flu information tracked by the King County Public Health and UW Virology Labs.  In addition, the report identifies a close relationship between patients in apartments/multi-family housing and flu-like symptoms. Future monitoring will focus on patients seen in these types of facilities as well as adult care facilities.

Use of Dispatch Protocols To Identify Flu-Symptoms:  This document describes the rationale for using dispatcher protocols in conjunction with the field reports and includes recommendations for refinements in the Infectious Disease Monitoring (a.k.a Sit Found) program.

August 4, 2009 Report:   A report on the infectious disease (flu-like illness) monitoring program was presented to the Fire Department Medical Director and research team, and Fire Department upper management and paramedics. 

Key findings:

1. 89% of the incidents identified by dispatchers as having flu-like symptoms also had flu symptoms found by firefighters at the scene.  In other words, dispatch EMD protocols matched the Sit Found program 89% of the time.

2. Individual symptoms - e. g., fever, cough, respiratory - do not appear to be a good indicator of flu illness.  Patients with fever or combination of flu-like symptoms appear to be a better measure of flu illness.

3. The Sit Found program accurately measured the outbreak of H1N1 in April 2009.  Data collected from April through June closely matched H1N1 cases identified by King County Public Health and University of Washington Virology laboratories.

4. The age and sex of patients with flu-like symptoms closely matched the age/sex profile of all patients. 

Recommendations from this report included:

Modify the First Watch program to track patients with fever (only) or combinations of other symptoms.

1. Use First Watch to track dispatcher protocols - specifically protocols involving fever, and fever with cough.

2. Stop tracking age and sex in the Sit Found program.  (The Sit Found program is intended for early warning of escalating events versus diagnosis.  The medical incident reports provide diagnostic details so it is not necessary to capture that in the Sit Found program.)